(This is the second in the series on the relationship between bisexuality and Borderline Personality Disorder.)

A study by Zubenko et al [1], using the sexual histories of patients who met standardized criteria for borderline disorder, found that 17 of the 61 men (21%) were homosexual, and 4 (5%) were bisexual compared with 7 (11%) of the 61 women. They concluded that homosexuality was 10 times more common among the men and 6 times more common among the women with borderline personality disorder than in the general population or in a depressed control group. Another study by Reich, and Zanarini,[2] concluded that same-gender attraction may be an important interpersonal issue for approximately one-third of both men and women with BPD. There were no significant differences between homosexual or bisexual orientation.

We can see from these studies that about a third of the people with BPD have some form of same-sex attraction. I was not able to locate information on the reverse to see how many bisexuals would be diagnosed with BPD, but I think we can extrapolate that the number is indeed significant. It is my belief that the majority of bisexual men and women may exhibit at least “some” of the BPD symptoms, even if they do not reach the level of a disorder where it would seriously affect their ability to function psychologically and socially.

So let’s take a look at the symptoms listed in the DSM4 (this appears to be much clearer that the DSM5). In general, it is, “A pervasive pattern of instability of interpersonal relationships, self image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five(or more) of the following:

1. Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
3. Identity disturbance: markedly and persistently unstable self image or sense of self.
4. Impulsivity in at least two areas that are potentially self damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or selfmutilating behavior covered in Criterion 5.
5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
7. Chronic feelings of emptiness.
8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
9. Transient, stress-related paranoid ideation or severe dissociative symptoms “

The first of these is a fear of abandonment. We will look at this one in detail next week.

Here are my five suggestions for bisexuals:

1. Do an inventory on the nine symptoms. Give yourself a rating between 1 and 10 with 10 being severe and frequent.
2. If your score is 25 or greater you may have a Borderline Personality Disorder.
3. If so you may wish to consider getting counselling.
4. Write down the symptoms that you have noted. We will be covering these items in future blogs.
5. If you know someone with BPD you may want to give them this website address.

[1] Zubenko, George S.; George, Anselm W.; Soloff, Paul H.; and Schulz, Patricia. Sexual practices among patients with borderline personality disorder. APA PsycNet, 2018.

[2] D. Bradford Reich, MD; Mary C. Zanarini, EdD. Sexual Orientation and Relationship Choice in Borderline Personality Disorder Over Ten Years of Prospective Follow-Up.  Journal of Personality Disorders > December 2008. Guilford Press Periodicals. Vol 22, Issue  6. 2018

Read More: https://guilfordjournals.com/doi/abs/10.1521/pedi.2008.22.6.564